Being overweight prior to transplant surgery slows improvement in the physical functioning of liver transplant patients
Research Activities, February 2010, No. 354
Approximately 30 percent of patients receiving liver transplants are obese. While obesity has not been found to influence survival after transplantation, a new study finds that being overweight or obese prior to the transplant slows improvement in the patient's physical health-related quality of life (HRQOL) compared with patients of normal weight. This is consistent with findings of less robust HRQOL among overweight or obese patients with chronic illness.
The patients used the Medical Outcomes Study Short Form 36 Health Survey to report their HRQOL before and after receiving a liver transplant. During the first year of followup after the liver transplant, both the mental and physical HRQOL improved over time for normal weight, overweight, and obese groups. Post-transplant differences in mental HRQOL by body mass index (BMI) were not significant. However, the improvement in physical HRQOL, which is linked to everyday functioning, was significantly greater during the first year after the transplant among patients with normal BMI compared with overweight or obese patients.
With longer followup, overweight and obese patients achieved comparable HRQOL scores, note the researchers. They collected data on HRQOL from 154 adult men and women who received liver transplants at a university transplant center between 2002 and 2008. The patients were grouped as normal weight (BMI = 18.5-24.9 kg/m2), overweight (BMI = 25.0-29.9 kg/m2), or obese (BMI ≥30.0 kg/m2). A combination of dietary counseling, physical exercise, and behavior therapy may help overweight and obese patients achieve better HRQOL during the first year after a liver transplant, suggest the authors. Their study was funded in part by the Agency for Healthcare Research and Quality (HS13833).
More details are in "The negative effect of pretransplant overweight and obesity on the rate of improvement in physical quality of life after liver transplantation," by Victor Zaydfudim, M.D., M.P.H., Irene D. Feuer, Ph.D., Derek E. Moore, M.D., M.P.H., and others in the August 2009 Surgery 146(2), pp. 174-180.